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Problems of older adults living alone after hospitalization

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Abstract

OBJECTIVE: To describe functional deficits among older adults living alone and receiving home nursing following medical hospitalization, and the association of living alone with lack of functional improvement and nursing home utilization 1 month after hospitalization.

DESIGN: Secondary analysis of a prospective cohort study.

PARTICIPANTS: Consecutive sample of patients age 65 and over receiving home nursing following medical hospitalization. Patients were excluded for new diagnosis of myocardial infarction or stroke in the previous 2 months, diagnosis of dementia if living alone, or nonambulatory status. Of 613 patients invited to participate, 312 agreed.

MEASUREMENTS: One week after hospitalization, patients were assessed in the home for demographic information, medications, cognition, and self-report of prehospital and current mobility and function in activities of daily living (ADLs) and independent activities of daily living (IADLs). One month later, patients were asked about current function and nursing home utilization. The outcomes were lack of improvement in ADL function and nursing home utilization 1 month after hospitalization.

RESULTS: One hundred forty-one (45%) patients lived alone. After hospital discharge, 40% of those living alone and 62% of those living with others had at least 1 ADL dependency (P=.0001). Patients who were ADL-dependent and lived alone were 3.3 (95% confidence interval [95% CI], 1.4 to 7.6) times less likely to improve in ADLs and 3.5 (95% CI, 1.0 to 11.9) times more likely to be admitted to a nursing home in the month after hospitalization.

CONCLUSION: Patients who live alone and receive home nursing after hospitalization are less likely to improve in function and more likely to be admitted to a nursing home, compared with those who live with others. More intensive resources may be required to continue community living and maximize independence.

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Author information

Authors and Affiliations

  1. the Department of Medicine, University of Wisconsin School of Medicine, and Geriatric Research Education and Clinical Center, William S. Middleton Memorial Veterans Hospital, Madison, Wis

    Jane E. Mahoney MD

  2. Institute on Aging, University of Wisconsin, Madison, Wis

    Jan Eisner RN

  3. Department of Biostatistics and Medical Informatics, University of Wisconsin, Madison, Wis

    Tom Havighurst MS

  4. School of Pharmacy, University of Washington, Seattle, Wash

    Shelly Gray PharmD

  5. Department of Preventive Medicine, University of Wisconsin School of Medicine, Madison, Wis

    Mari Palta PhD

Authors
  1. Jane E. Mahoney MD
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  2. Jan Eisner RN
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  3. Tom Havighurst MS
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  4. Shelly Gray PharmD
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  5. Mari Palta PhD
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Additional information

This work was supported by grants from the American Physical Therapy Foundation, the Dean Foundation, and the University of Wisconsin Medical School and Graduate School. Dr. Mahoney was the recipient of a Clinical Investigator Award from the NIA (K08AG00623).

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Mahoney, J.E., Eisner, J., Havighurst, T. et al. Problems of older adults living alone after hospitalization. J GEN INTERN MED 15, 611–619 (2000). https://doi.org/10.1046/j.1525-1497.2000.06139.x

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